Hi Fsansi,

I will offer you information based on my professional experience in the dental field. Not to sound insensitive toward the dental profession but general dentists are educated people <in the field of tooth carpentry>. They are not well educated in the systemic problems that arise from unhealthy teeth. This is why they often seem puzzled or suggest a wait and see approach when the root canaled teeth are having problems without obvious pathology. In other words the "tooth carpentry" has been performed... so what could possibly be wrong?

The first problem I see is the 3 root canaled teeth. One root canaled tooth contains diseased nerve tissue and is chronically inflamed. Times that by 3 and you can imagine the havoc going on in that area of your mouth. To make matters more intense your sinuses are in close proximity to these 3 upper teeth which means they could also be inflamed.

To tell a patient that the dental xray of a root canaled tooth is normal means nothing obvious is showing on the film. However, the bacteria residing inside of the tooth cannot be seen on the xrays until it proliferates from the tooth into the bone. Even then it is not always picked up because dental xrays are only two dimensional and depending on how the film is angled the pathology may or may not show at a different angle.

I'm guessing your primary care doctor checked up your nose and didn't see any pus so he thinks all is good. Yes? The sinus xray again if it wasn't a dental ct scan taken in slices it may not show anything more than the 2 dimensional dental xray. Again not to be insensitive to the medical profession but physicians are not educated in dental health and they are not apt to know how to treat a patient with a dental problem.

The basic blood work to check for infection will only show elevated markers depending on the severity of the infection. Did he do a C-reactive protein, Erythrocyte sedimentation rate, Plasma viscosity, Fibrinogen, Ferritin, or any other tests that could indicate inflammation or bacterial infection?

The osteoporosis drug Prolia is in a class of drugs referred to as Bisphosphonates. Have you read about Prolia and the possible side effects associated with the jaw bone? Infected teeth, root canaled teeth and periodontal disease all have bacteria related problems which can cause the jaw bone to a break down. People who take Bisphosphonate drugs are at a high risk compared to those who do not take them for developing osteonecrosis of the jaw bone which results in further bone loss and often infection. This can be very progressive and painful. An oral surgeon could be helpful in diagnosing this.

I personally think the origin of your bacterial issues have stemmed from your unhealthy root canaled teeth and quite possibly the Prolia. But at this point I doubt that you have Trigeminal neuralgia... not that it can't progress to that. I just don't think that is what it is now.

What did the ENT dr say?